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Medial Lower Leg


Examples of Conditions Treated:

Shin splints
Shin splints is a generic term used to describe pain in the front of your lower legs during activity. Pain is usually diffuse, dull and aching. You are at greater risk of getting shin splints if:

  • You have been running for less than five years
  • You run on hard surfaces or slopes
  • You are overweight
  • You overpronate (if your feet roll inwards or if you have flat      feet)
  • You have short or tight calf muscles
  • You wear incorrect footwear that is either worn out or doesn’t provide the correct support for your foot posture when you run

Medial Tibial Stress Syndrome
MTSS is the most common cause of pain in the lower leg. The periosteum is a layer of connective tissue that surrounds bone. The muscles that move your foot and ankle attach to the front of the tibia (shin) and fuse with the periosteum.  The periosteum can become inflamed in response to the stresses placed upon it. This will normally occur over a long period of weeks or months; however it can also be provoked after just one bout of intense exercise.

Compartment Syndrome
Muscles demand an increased blood supply to deliver oxygen during periods of intense exercise. The muscles of the lower limb lie in compartments. These compartments are effectively groupings of muscles, but also include veins, arteries and nerves. The compartments are encased  in a strong connective tissue (fascia) that doesn’t stretch. Blood comes into and engorges the muscle tissue but the inelastic fascia tissue provides an opposing force. Pressure builds up and blood flow is compromised affecting oxygen delivery and removal of metabolic waste.

The pain of exertional compartment syndrome only comes on with exercise. It can be felt in the front, side or back of the leg and, sometimes, in all three. Unlike the pain of Medial Tibia Stress Syndrome, the pain caused by compartment syndrome quickly subsides when exercise ceases.

Acute compartment syndrome is a medical emergency and is rare. It is often the result of trauma. It can affect any muscle in your body, and should be suspected if the area becomes increasingly more painful, swollen, red and hot in the few hours after an injury.

Tibial Stress fractures
These are hairline cracks in the bone secondary to overload. Stress fractures can be caused by a sudden increase in training (mileage, intensity, frequency). They can also be caused by a change in terrain altering your biomechanical loading whilst running. Biomechanical imbalance within the body and nutritional deficiencies (too few calories to compensate for the energy burned during activity) can also be causative factors.